contact your local wic agency at: kansas wic · 1 2 d 3 • family 4 5 d o or ntrition ecation...

USDA is an equal opportunity provider and employer.

Kansas Department of Health and EnvironmentBureau of Family HealthNutrition and WIC Services1000 SW Jackson, Suite 220Topeka, KS 66612

KANSAS KANSAS

The information in this booklet is subject to change.

• Handle your WIC checks carefully – like they are cash.

• Shop for WIC foods at Kansas authorized grocery stores displaying the “We Accept WIC Checks” door decal.

• Always take your WIC Program Booklet with you to shop for WIC foods.

• Contact your local WIC agency right away if something happens to your checks. Checks are replaced only in special cases.

SHOPPING TIPS & REMINDERS • Contact your local WIC agency to make any

changes on your WIC checks.

• Select the correct package sizes. Carefully count ounces to be at or under the maximum amount printed on your check.

• WIC foods cannot be returned to the store for credit or cash or exchanged for other items.

• Be polite to the cashier.

Contact your local WIC Agency at:

What to bring to the grocery store:

WIC Program Booklet

WIC Checks

Photo Identification/WIC Program Identification Card

VIEW YOUR WIC INFORMATION• Current and past appointment details• What you need to bring to your appointment• Review your nutrition goals• Text message reminders• Q&A

HOW DO YOU SIGN UP?Go to www.kswic.com to register.You will need the following information:• WIC ID number for a person in your family (Found on

your WIC checks to the left of the client name)• Birth date for the person whose ID number you entered• Email address

The Kansas WIC Client Portal

K AN SA SK AN SA S

www.kansaswic.org

K A N S A S W I C

EFFECTIVE OCTOBER, 2015

Program Booklet

K AN SA SK AN SA S

INFORMATION FOR CLIENTS

Department of Healthand Environment

Buying, selling, or otherwise misusing WIC benefits is a crime. To report suspected fraud or abuse, call 800-424-9121 or visit www.usda.gov/oig/hotline.htm

KansasWIC-ProgramBook15-Cover_Eng.indd 19/28/15 2:13 PM

Follow these easy steps:

1 Go to wichealth.org

2 Create an account and set up your profile

3 Complete a lesson from one of the 5 categories: Pregnant Women, Children 0-1, Children 1-5, Family, Parents

4 Fill out the survey

5 Print or email your certificate of completion

Do your nutrition education ONLINE.

Connecting for a healthy futureWIC is a nutrition program that provides nutrition and health education, breastfeeding support, healthy food and referrals to other services free of charge to Kansas families who qualify. WIC stands for the Special Supplemental Nutrition Program for Women, Infants and Children.

WIC OFFERS FAMILIES:

• Breastfeeding promotion and support

• Checks to buy healthy food

• Health and social service referrals

• Immunization screening and referrals

• Tips for eating well to improve health

WIC NUTRITION STAFF MEET WITH EACH WIC CLIENT TO:

• Review diet and health behaviors

• Provide individual nutrition advice

• Support families making changes for better health

• Offer a selection of healthy foods

For more information about the Kansas WIC Program and/or Nutrition and Breastfeeding Education go to: www.kansaswic.org

WIC provides good food and a whole lot more

ID:

Username:

Password:

WIC Clinic:

KansasWIC-ProgramBook15-Cover_Eng.indd 2 9/28/15 2:13 PM

BREAKFAST CEREALS

• All Bran*• Corn Flakes• Crispix• Frosted Mini-Wheats

Little Bites*• Frosted Mini-Wheats

Original*• Frosted Mini-Wheats

Touch of Fruit Raisin*• Frosted Mini-Wheats

Touch of Fruit Raspberry*

• Rice Krispies

• Bran Flakes*• Corn Bitz• Corn Flakes• Crispy Hexa-Grains*• Crispy Rice• Frosted Shredded Wheat*• Frosted Shredded Wheat

- Blueberry*• Frosted Shredded Wheat

- Strawberry Cream*• Honey Crisp Medly w/

Almonds• Honey Crisp Medly• Living Well*• Living Well Multigrain*• Multigrain Toasted Oats*• Nutty Nuggets*• Oat Squares*• Rice Bitz• Toasted Oats*

• Bran Flakes*• Corn Biscuits• Corn Flakes• Crispy Hexagon• Crispy Rice• Nutty Nuggets*• Oats & More with

Almonds• Rice Biscuits• Tasteeos*• Toasted Oats*

• Berry Berry Kix*• Cheerios*• Cheerios + Ancient

Grains*• Corn Chex• Dora the Explorer• Fiber One Honey

Clusters*• Honey Kix*• Kix*• Multi Grain Cheerios*• Rice Chex• Wheat Chex*• Wheaties*• Whole Grain Total*

• Bite Size Frosted Shredded Wheat*

• Bran Flakes*• Corn Flakes• Crisp Rice• Crunchy Nuggets*• Crunchy Oat Squares*• Honey Oats and Flakes• Toasted Corn• Toasted MultiGrain*• Toasted Rice• Toasted Wheat*• Toasted Whole Grain

Oats*

• Blueberry Mini Spooners*

• Corn Flakes• Crispy Rice• Frosted Mini

Spooners*• Oat Blenders w/

Honey• Scooters*• Strawberry Cream

Mini Spooners*

• Corn Flakes• Frosted Shredded

Wheat*• Frosted Strawberry

Shredded Wheat*• Honey & Oat Mixers• Toasted Oats*• Toasted Rice

*Indicates cereals made with whole grain

• Bran Flakes*• Corn Biscuits• Corn Flakes• Crispy Rice• Crispy Hexagons• Essentially You• Frosted Shredded

Wheat*• Frosted Bite size Shredded

Wheat - Blueberry*• Frosted Shredded Wheat

- Strawberry Cream*• Multigrain Tasteeos*• Nutty Nuggets*• Oats & More w/ Honey• Oats & More w/ Almonds• Oat Wise*• Rice Biscuits• Simple Living*• Tasteeos*• Toasted Corn Squares• Toasted Rice Squares• Wheat Biscuits*• Wheat Flakes*

• Bran Flakes*• Corn Biscuits• Corn Flakes• Crispy Hexagons• Crispy Rice• Essentially You• Frosted Shredded

Wheat*• Nutty Nuggets*• Oats & More w/Almonds• Oats & More w/Honey• Oat Wise*• Rice Biscuits• Tasteeos/Toasted Oats*• Wheat Biscuits*

• 4 Corner Crunch Original*

• Corn Biscuits• Corn Flakes• Crispy Hexagons• Crispy Rice• Essentially You• Frosted Shredded Wheat*• Frosted Shredded Wheat

- Strawberry Cream*• Bran Flakes*• Multigrain Toasted Oats*• Nutty Nuggets*• Oats and More w/Almonds• Oats and More w/Honey• Oat Wise*• Rice Biscuits• Toasted Oats*• Wheat Biscuits*

KasnasWIC-ProgramBook15-Interior_Eng.indd 13 9/10/15 10:34 AM

12, 16, 20 or 24 oz packagesProduct labels for breads/rolls/buns must include the words 100% Whole Wheat. Whole wheat flour must be the first ingredient listed.

Brands that have 100% Whole Wheat products to meet the above criteria include:

100% WHOLE WHEAT BREAD, ROLLS & BUNS

WHOLE GRAINS

Things to look for when buying whole wheat bread...

STEP 1: Check the Label

Label says “100% Whole Wheat”

STEP 3: Check Ounces in Product

Make sure you don’t go over the ounces listed on your WIC check

STEP 2: Check the Ingredient List

Whole Wheat flour is the first ingredient listed


JUICE

SHELF STABLE 64 oz only

Apple or Premium Apple

Apple, Grape,

White Grape, Just Juice Apple, Just Juice Berry,

Just Juice Cherry, Just Juice Fruit

Punch or Just Juice Grape

Apple,Apple Kiwi Strawberry,

Apple Orange Pineapple,

Apple Peach Mango or

Grape Juice Plus

Any flavor with 100% juice on

the label

Apple, Berry, Cherry Punch, Fruit Punch,

Grape, Grape Blend or White

Grape

Any flavor Apple, Berry, Cherry, Grape, Punch, Grape

Blend or White Grape

Apple, Grape, White Grape,

or White Grape Peach

Any flavor Apple, Grape, White Grape or

White Grape Peach

Apple, Grape or White Grape

Apple Apple, Grape, White Grape,

Juice-A-Lot Berry, Juice-A-Lot

Cherry, Juice-A-Lot Grape or

Juice-A-Lot Punch

Apple or Grape Apple, Apple Berry,

or Apple Grape

Apple

Big Bird Apple,Elmo’s Punch,Grover’s WhiteGrape or Bert &

Ernie’s Berry


How to Use a Fruit and Vegetable Check

• The Fruit and Vegetable Check has a maximum dollar amount printed on it. If you have fruits and vegetables that exceed the dollar amount on the Fruit and Vegetable Check you can:

- Pay the difference using cash, credit/debit card, check or Vision card benefits.

- Pay the difference using multiple Fruit and Vegetable Checks together.

• Tax will be applied to the difference if you pay with cash, credit/debit, or check.

• Tax will not be applied to the difference if you pay with Vision card benefits or another Fruit and Vegetable Check.

• If your fruit and vegetable purchase doesn’t add up to the Fruit and Vegetable Check amount, you will not receive change back.

FRUITS & VEGETABLES


Dried Beans/Peas Canned Beans Fish

Up to 1 lb bagAny brand

Your choice of:• Dried Beans• Peas• Lentils

CANNOT BUY: soup mixes

• Black Beans• Black-Eyed Peas• Fat-Free Refried

Beans• Garbanzo Beans

(Chick Peas)• Great Northern

Beans

• Kidney Beans• Lentils• Lima or Butter

Beans• Navy Beans• Pinto Beans• Split Peas

5 - 15 oz containersAny brand

Available to exclusively breastfeeding mothers and pregnant or breastfeeding mothers with twins or triplets.

LIGHT TUNA, CHUNK• Packed in water or oil

PINK SALMON• Packed in water or oil

CANNOT BUY: albacore tuna, tuna spreads, or any other type of salmon, lunch packs or fish with added flavoring

CANNOT BUY: green beans, baked beans, flavored beans, pork and beans or chili beans, soups, beans containing added sugars, fats, meats or oils

YOGURT/SOY BEVERAGE/TOFU/PEANUT BUTTER/BEANS/FISH

16 oz containers• Nasoya - Silken• Azumaya - Firm• House - Medium

Firm, Firm and Extra Firm

15 - 16 oz canAny brand


MILK, EGGS, & CHEESE MUST BE STORE BRAND OR LEAST EXPENSIVE BRAND AVAILABLE

Milk Eggs Cheese

Type and container size as listed on the checkYour choice of:• Grade AA Large• Grade A Large

CANNOT BUY: brown, free-range, specialty eggs or organic

One 16 oz package or two 8 oz packages Your choice of:• Pasteurized Processed American (sliced)• Cheddar (block)• Cojack (block)• Colby (block)• Monterey Jack (block)• Mozzarella (block)• Swiss (block)

CANNOT BUY: imported cheese, cheese food, product or spread, shredded cheese, cheese with added flavors, individually wrapped slices or organic

The brand, type and size as listed on the check.

CANNOT BUY: any other brand, type or size

BABY FOOD/INFANT CEREAL/INFANT FORMULA/MILK/EGGS/CHEESE

One Dozen

All authorized milk is fortified with Vitamin D.

*Only for certain medical conditions. ** Does not meet minimum nutrition requirements.

• No Fat (Skim)• Lowfat Options (½%, 1%) • Reduced Fat (2%)*• Whole Milk (for 12-24

months old)• Fat free, Lowfat or Reduced

Fat Lactose Free

• Whole Lactose Free• Fat Free or Lowfat

Evaporated• Whole Evaporated• Nonfat Dry

CANNOT BUY: buttermilk, flavored milk, raw unpasteurized milk, non-dairy milk substitutes**, rice milk**, organic milk, almond milk**, coconut milk** or in glass containers


What to bring to your WIC Appointment:Proof of Identity (Examples)

• Photo identification• Driver’s license• School identification• Birth certificate• Kansas Medicaid card• Passport• Military identification

Proof of Identity for Child/Infant (Examples)• Birth certificate• Foster care/adoption papers• Kansas Medicaid card• Immunization records

Proof of where you are currently living (Examples)• Utility bill• Rent receipt• Lease/Housing Agreement• Envelope that was mailed to you

Current Proof of Household Income for all people living in your house (Examples)• Paystubs from the most current job(s) to equal

30 days or 4 weeks• DCF benefit letter• Medicaid card/KanCare card• Additional income information (child support,

unemployment, etc.)• Recent 1040 tax statement if self-employed

WIC cannot accept Social Security Cards as proof of identity.

On the appointment

day, be sure to bring the papers you were asked

to provide.























ID:

Username:

Password:

WIC Clinic:























ID:

Username:

Password:

WIC Clinic:



Infant Formula

Infant Cereal

4 oz containers• Single or mixed fruits• Single or mixed vegetables • No added sugar, starch or salt• No added DHA/ARA

CANNOT BUY: desserts, dinners, cobblers, delights or organic

8 oz box or largerYour choice of:• Barley • Mixed• Oatmeal • Rice• Whole Wheat

CANNOT BUY: cereal with added fruit, formula, DHA/ARA or organic



2½ oz containers Available to exclusively breastfed babies only.

• Single meats with broth • Single meats with gravy

CANNOT BUY: dinners or organic

Brands that have products to meet the criteria for baby food and infant cereal include: Beechnut, Gerber, Tippy Toes, Kroger and Up & Up

Baby Food

FRUITS & VEGETABLES

MEATS

TIP: When buying baby food fruit and vegetables, a 2-pack is counted as 2 containers.

=2


BREAKFAST CEREALS






• Rice Krispies












Oats*





Mini Spooners*


















WHOLE GRAINS









JUICE



Apple, Grape,







Grape Juice Plus


the label



Grape






White Grape Peach





Juice-A-Lot Punch


or Apple Grape

Apple


Ernie’s Berry









FRUITS & VEGETABLES









Beans















Milk Eggs Cheese

Type and container size as listed on the checkYour choice of:• Grade AA Large• Grade A Large

CANNOT BUY: brown, free-range, specialty eggs or organic

One 16 oz package or two 8 oz packages Your choice of:• Pasteurized Processed American (sliced)• Cheddar (block)• Cojack (block)• Colby (block)• Monterey Jack (block)• Mozzarella (block)• Swiss (block)

CANNOT BUY: imported cheese, cheese food, product or spread, shredded cheese, cheese with added flavors, individually wrapped slices or organic



BABY FOOD/INFANT CEREAL/INFANT FORMULA/MILK/EGGS/CHEESE

One Dozen

All authorized milk is fortified with Vitamin D.

*Only for certain medical conditions. ** Does not meet minimum nutrition requirements.

• No Fat (Skim)• Lowfat Options (½%, 1%) • Reduced Fat (2%)*• Whole Milk (for 12-24

months old)• Fat free, Lowfat or Reduced

Fat Lactose Free

• Whole Lactose Free• Fat Free or Lowfat

Evaporated• Whole Evaporated• Nonfat Dry

CANNOT BUY: buttermilk, flavored milk, raw unpasteurized milk, non-dairy milk substitutes**, rice milk**, organic milk, almond milk**, coconut milk** or in glass containers























ID:

Username:

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WIC Clinic:


Peanut ButterSoy Beverage

Tofu

16 - 18 oz jarAny brand• Smooth/Creamy• Crunchy

CANNOT BUY: peanut butter spreads, peanut butter with added flavors, fortified peanut butter, natural or organic

(Original/Plain or Vanilla)

Half gallon (64 oz) containers only



Yogurt

(Whole, lowfat & nonfat) Brand specific

32 oz. containers

• Coburn Farms• Dannon Naturals• Great Value• Hy-Vee• Kroger

• Market Pantry• Mountain High• Our Family• Shurfine• Yoplait

CANNOT BUY: any other size, container, type, flavor, brand, with added artificial sweeteners, mix-in ingredients (such as granola, candy pieces, honey, nuts and similar ingredients), Greek, Organic or Drinkable

Flavors include: Original/Plain, Vanilla or Strawberry

CANNOT BUY: any other size, container, type, flavor or brand

CANNOT BUY: any other size, container, type, flavor or brand

• 8th Continent• Silk - original only• WestSoy


BREAKFAST CEREALS






• Rice Krispies












Oats*





Mini Spooners*


















WHOLE GRAINS









JUICE



Apple, Grape,







Grape Juice Plus


the label



Grape






White Grape Peach





Juice-A-Lot Punch


or Apple Grape

Apple


Ernie’s Berry









FRUITS & VEGETABLES









Beans



































ID:

Username:

Password:

WIC Clinic:


FRESH FRUITS & VEGETABLES

Fruits & Vegetables

• Any variety of fresh, bulk fruits and vegetables

• Bagged salad mixes

• Bagged vegetables

• Bagged fruit

• Cut fruit or vegetables

CANNOT BUY: canned, frozen, items from the salad bar, party trays, fruit baskets, decorative fruits or vegetables, nuts, herbs or spices (e.g. garlic, cilantro, parsley, etc.)

TIP: Eating fresh fruits and vegetables is as easy as:

• Rinse and eat• Peel and eat• Slice and eat


BREAKFAST CEREALS






• Rice Krispies












Oats*





Mini Spooners*


















WHOLE GRAINS









JUICE



Apple, Grape,







Grape Juice Plus


the label



Grape






White Grape Peach





Juice-A-Lot Punch


or Apple Grape

Apple


Ernie’s Berry









FRUITS & VEGETABLES























ID:

Username:

Password:

WIC Clinic:


Only the container size and quantity listed on the WIC Check.

ORANGE JUICEAny brand• Concentrate (frozen or non-frozen) 11.5-12 oz• 64 oz shelf stable• With or Without Calcium

• No sugar added• No organic or DHA• No infant juice

100% FRUIT JUICE ONLY

• No refrigerated• No juice cocktails,

drinks or ades

FROZEN CONCENTRATE 11.5 - 12 oz only

Any flavor with a yellow band

Apple or Grape

Apple Apple, Grape or Pineapple

Orange

Any flavor with a green lid

Apple

AppleGrape

Apple Apple

Any flavor with a yellow band

NON-FROZEN CONCENTRATE

Apple WIC Approved

K AN SA SK AN SA S

KsWIC_ShelfLabels_FullSize.indd 1 6/15/15 1:47 PM

11.5 - 12 oz only

Juice

Look for WIC Approved

shelf tags

Apple or Grape


BREAKFAST CEREALS






• Rice Krispies












Oats*





Mini Spooners*


















WHOLE GRAINS









JUICE



Apple, Grape,







Grape Juice Plus


the label



Grape






White Grape Peach





Juice-A-Lot Punch


or Apple Grape

Apple


Ernie’s Berry























ID:

Username:

Password:

WIC Clinic:


Whole Grains

Any brand

• Best Choice• Chi Chi’s • Don Pancho• Food Club• Guerrero• Hy-Vee

• IGA• Kroger• La Banderita• La Burrita• Mama Lupe• MiCasa

• Mission• Ortega• Our Family• Santa Fe• ShurFine

SOFT CORN TORTILLAS:

CANNOT BUY: any other brand

16 oz packages

• Yellow or White

TORTILLAS

16 oz only

WHOLE WHEAT PASTA

Any brand

BROWN RICE

• Barilla - Whole Wheat Penne - Whole Wheat Spaghetti• Full Circle

CANNOT BUY: Any other brand or products that have added sugars, fats, oils or salt (i.e. sodium)

16 oz containers • Regular• Quick (16 oz)

CANNOT BUY: products with added sugar, salt, flavoring, fat or oil

14 oz containers• InstantWHOLE WHEAT TORTILLAS:

• Kroger• ShurFine• Simple Truth• Nash Bro Trading Co.

• Natural Directions• Hodgson Mill • Racconto• Ronzoni


BREAKFAST CEREALS






• Rice Krispies












Oats*





Mini Spooners*


















WHOLE GRAINS






























ID:

Username:

Password:

WIC Clinic:


Good Source of Iron, Folic Acid and Other Important Nutrients

CANNOT BUY: any cereal or brand not listed, or organic cereal






Oats*


Wheat*• Happy O's*• Oats & More w/Almonds• Oats & More w/Honey• Oat Wise*• Rice Biscuits• Wheat Biscuits*

Breakfast Cereals

COLD CEREAL 11 oz or larger, not to exceed 36 oz









BREAKFAST CEREALS






• Rice Krispies












Oats*





Mini Spooners*















Ways to Buy 36 oz of Cereal...

BREAKFAST CEREALS

• Creamy Wheat Farina

• Regular Flavor Instant Oatmeal*

• Cream of Rice• Cream of Wheat (1 Minute)• Cream of Wheat (10 Minute)• Cream of Wheat (2½ Minute)• Cream of Wheat Instant• Cream of Rice Instant• Healthy Grain Cream of Wheat Instant*• Whole Grain Cream of Wheat*


• Instant Oatmeal Original Flavor*

• Grits Instant Butter Flavor

• Instant Oatmeal Regular Flavor*

• Chocolate Hot Wheat Cereal

• Original Hot Wheat Cereal

CANNOT BUY: any cereal or brand not listed, or organic cereal

• Instant Oatmeal Regular*


• Instant Regular Oatmeal*


• Instant Oatmeal Regular Flavor*

• Instant Grits Original

• Instant Oatmeal Original*


11 oz or larger, not to exceed 36 ozHOT CEREAL




Ways to Buy 36 oz of Cereal...

= 36 oz36 oz= 36 oz+ +12 oz 12 oz12 oz = 36 oz+18 oz 18 oz = 36 oz+ 24 oz12 oz


• Corn Flakes• Corn Squares• Crisp Rice• Crispy Rice• Crunchy Corn• Crunchy Corn & Rice• Crunchy Rice• Crunchy Wheat

Squares*• Enriched Bran Flakes*• Frosted Shredded

Wheat*• Frosted Shredded Wheat

Bite Size*• Honey, Oats & Flakes w/Almonds• Multigrain Medley*• Nutty Nuggets*


Wheat*• Oats & More • Oats & More w/Almonds• Oat Wise*• Rice Biscuits• Tasteeos* w/Honey

• Life *• Oatmeal Squares

Cinnamon*• Oatmeal Squares

Golden Maple*• Oatmeal Squares Hint of

Brown Sugar*• Oatmeal Squares Honey

Nut*

• Alpha-Bits*• Banana Nut Crunch*• Bran Flakes*• Grape Nuts*• Grape Nuts Flakes*• Honey Nut Shredded

Wheat*• Honey Bunches of Oats

Whole Honey Roasted• Honey Bunches of Oats

w/Almond Bunches• Honey Bunches of Oats

w/Cinnamon Bunches• Honey Bunches of Oats

Whole Grain Honey Crunch*

• Honey Bunches of Oats Whole Grain w/Vanilla Bunches*

• Oats & More w/Almonds & Honey Oat Clusters

• Oats & More w/Honey Oat Clusters

• Oat Wise*• Rice Squares• Toasted Oats*• Wheat Bran*• Wheat Squares*


1) Select a Kansas WIC authorized store.

2 Make sure your name is listed under the signature line.• Only the names listed can use the WIC check.• Contact your local WIC agency if the name(s) need to be changed.

How to Use a WIC Check

3

4

8

10

2


YOUR RIGHTS & RESPONSIBILITIES

• My WIC information may be released to designated public organizations and their programs to see if I qualify for their services, to conduct outreach, to share needed health information with programs I am already participating in, to streamline office procedures, and to help assess the overall health of Kansas families. The designated programs are: Other state and local WIC programs, non-WIC programs administered by the WIC state and local agency, Maternal & Child Health, School Health, Family Planning, Statewide Farmworker Health, Maternal and Infant, Healthy Start/Home Visitor, Immunizations, Special Health Care Needs, Infant Toddler, Parents as Teachers, Kansas Childhood Lead Poisoning Prevention, Head Start, KanCare, Temporary Assistance for Needy Families, Kansas Food Assistance, Medicaid, KAN Be Healthy, Dept. of Education Child Nutrition and Wellness Programs, Expanded Food Nutrition Education Programs, Military Family Support Services, Becoming a Mom and Smoking Cessation Programs.

I have been advised of my rights and responsibilities under the Program. I certify that the information I have provided for my eligibility determination is correct, to the best of my knowledge. This certification form is being submitted in connection with the receipt of Federal assistance. Program officials may verify information on this form. I understand that intentionally making a false or misleading statement or intentionally misrepresenting, concealing, or withholding facts may result in paying the State agency, in cash, the value of the food benefits improperly issued to me and may subject me to civil or criminal prosecution under State and Federal law.

The U.S. Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities).

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866)632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202)690-7442 or email at [email protected].

Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800)877-8339; or (800)845-6136 (Spanish). USDA is an equal opportunity provider and employer.

I understand my rights and responsibilities in the WIC Program.


3 Check the dates.

• Only use the WIC check on or between the “do not use before” and “do not use after” dates printed in the upper right corner of the check.

4 Choose the items you want to buy from the “Authorized Food” list printed on the WIC check.• You do not have to buy all the items listed on the check.• Rain checks for out of stock items are not allowed. • If a store offers you a rain check, report the store to your local WIC agency.• If the store does not have the item(s) you need, please ask for assistance before checking out. Not all WIC foods will be

available in every WIC approved grocery store.

5) Refer to the WIC approved foods section of this booklet for details about brands, sizes, types, and flavors.

6) When checking out at the cash register • Tell the cashier you will be using a WIC check and give him/her the check before the order is processed.• Group WIC foods together according to what is listed on each check.• Keep WIC foods separate from any other foods you may buy.

7) Show the cashier your Photo Identification/WIC Program Identification Card.

8 After scanning your items, the cashier will record the total dollar amount of your WIC foods, date, and initial your check.

9) The cashier will hand the check back for you to sign. Never sign a WIC check before the “Pay Exactly” section has been filled in.

10 Verify that all information is correct and sign the WIC check.

HOW TO USE A WIC CHECK


1) Select a Kansas WIC authorized store.

2 Make sure your name is listed under the signature line.• Only the names listed can use the WIC check.• Contact your local WIC agency if the name(s) need to be changed.

How to Use a WIC Check

3

4

8

10

2


Your Rights & Responsibilities

I AGREE TO:• Attend all scheduled nutrition education classes and appointments.• Be on time for all appointments.• Let WIC staff know in advance if I cannot keep an appointment.• Bring proof of current income, address, and identification for each person applying.• Give the WIC staff truthful information about my or my child’s medical history, my household income and the foods that I eat or my child eats.• Have my or my child’s weight, height and blood checked (finger or heel stick) and a diet assessment.• Handle my WIC checks carefully - like they were cash.• Call the WIC office right away if my checks are damaged, lost, or stolen. Checks are replaced only in special cases.• Buy only WIC foods with WIC checks.• Let the WIC staff know if my address, telephone number or income changes, if I am going to move away or if I no longer have custody of the client.

I UNDERSTAND THAT:• WIC will give me checks to buy certain foods at WIC authorized grocery stores each month.• WIC will provide referrals to other helpful programs and health services. I am encouraged to participate.• I may be dropped from WIC if I participate in more than one WIC Program in any one month.• Standards for eligibility and participation in the WIC Program are the same for everyone, regardless of race, color, national origin, sex, age or disability.• I may appeal any decision made by the local agency regarding my eligibility for WIC.• It is illegal to participate in more than one WIC program in any one month. I may be dropped from WIC if I or someone with me makes changes on my WIC check; returns WIC foods for cash or non-WIC foods; sells, trades or gives away WIC foods; buys non-WIC foods; uses an unauthorized vendor; or verbally or physically abuses WIC or vendor staff. I also may be required to repay benefits.

For the Kansas Department of Health and Environment WIC Program


YOUR RIGHTS & RESPONSIBILITIES

• My WIC information may be released to designated public organizations and their programs to see if I qualify for their services, to conduct outreach, to share needed health information with programs I am already participating in, to streamline office procedures, and to help assess the overall health of Kansas families. The designated programs are: Other state and local WIC programs, non-WIC programs administered by the WIC state and local agency, Maternal & Child Health, School Health, Family Planning, Statewide Farmworker Health, Maternal and Infant, Healthy Start/Home Visitor, Immunizations, Special Health Care Needs, Infant Toddler, Parents as Teachers, Kansas Childhood Lead Poisoning Prevention, Head Start, KanCare, Temporary Assistance for Needy Families, Kansas Food Assistance, Medicaid, KAN Be Healthy, Dept. of Education Child Nutrition and Wellness Programs, Expanded Food Nutrition Education Programs, Military Family Support Services, Becoming a Mom and Smoking Cessation Programs.

I have been advised of my rights and responsibilities under the Program. I certify that the information I have provided for my eligibility determination is correct, to the best of my knowledge. This certification form is being submitted in connection with the receipt of Federal assistance. Program officials may verify information on this form. I understand that intentionally making a false or misleading statement or intentionally misrepresenting, concealing, or withholding facts may result in paying the State agency, in cash, the value of the food benefits improperly issued to me and may subject me to civil or criminal prosecution under State and Federal law.

The U.S. Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities).

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866)632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202)690-7442 or email at [email protected].

Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800)877-8339; or (800)845-6136 (Spanish). USDA is an equal opportunity provider and employer.

I understand my rights and responsibilities in the WIC Program.























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KANSAS KANSAS













WIC Program Booklet

WIC Checks






K AN SA SK AN SA S

www.kansaswic.org

K A N S A S W I C


Program Booklet

K AN SA SK AN SA S




KansasWIC-ProgramBook15-Cover_Eng.indd 19/28/15 2:13 PM

ReferralsCheck with your local Health Department or the Department for Children and Families (DCF) to apply for KanCare, Child Support Services, Temporary Assistance for Needy Families, and/or Food Assistance Program. You may also apply online at: www.dcf.ks.gov

To stop smoking call the Kansas Tobacco Quitline: 1-800-QUIT-NOW (1-800-784-8669)

Ask your local WIC staff about services in your area.

Exclusively breastfeeding mothers and their babies receive extra food benefits.




K AN SA SK AN SA S













WIC Program Booklet

WIC Checks






KANSAS KANSAS

www.kansaswic.org

KANSAS WIC


Program Booklet

KANSAS KANSAS





contact your local wic agency at: kansas wic · 1 2 d 3 • family 4 5 d o or ntrition ecation...

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